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'Only The Tip Of XDR-TB
Iceberg' Visible Warn Doctors

By Adriana Stuijt
Exclusive to Rense.com
"We see only the tip of the iceberg of XDR-TB" - warns Doctors without Borders
TB+HIV epidemics worsened by a very severe health worker shortage in SAfrica...'
June 22 2007 - Dr Eric Goemaere, head of Doctors without Borders in South Africa, issued an urgent call late last year to health workers worldwide over Voice of America radio broadcasts to sign up for jobs there. He warned that due to the "very severe" shortage of doctors and nurses at their clinics treating co-infected TB+HIV patients, many now have to forego treatment and new patients cannot be diagnosed.
Hear his Voice of America broadcast on:
3 to 6-million people co-infected with TB+HIV in South Africa will die of XDR-TB
"We can try to control the damage that we see today from drug- resistant TB," Dr. Goemaere said on June 21 2007. "But we are only seeing the tip of the iceberg". He spoke in reaction to the World Health Organisation's new plan to contain drug-resistant Tuberculosis worldwide:
Read The Plan:
South Africa has the largest number of people with Hiv-Aids in the world, with about six million people infected -- and 60% (3.6- million) of those people also are co-infected with TB+HIV, according to Dr Goemaere's clinical findings.
This co-infection becomes progressively untreatable with any available drugs and ultimately leads to their deaths from Extremely- Drug-Resistant Tuberculosis. (XDR-TB)
In South Africa, their death is hastened even more with the uniquely South African strain of XDR-TB called SA-1, which is a mutation of the tuberculosis bacillus and the human-immune- deficiency virus.
Patients with the SA1 strain are seen to die within 20 to 25 days according to the World Health Organisation.
Listen to NPR radio's interviews with South African doctors at two TB-hospitals in Nov. 2006:
In 1999, Doctors without Borders set up their first integrated clinic to address the co-infection of tuberculosis plus the Aids- virus at the gigantic Ubuntu clinic in the large Khayelitsha township about 30km from Cape Town. They also opened another clinic in Lusikisiki in the Eastern Cape.
120-year-old sputum test:
The diagnostic tools and treatments remain limited and archaic, Doctors without Borders warn.
"To diagnose Tuberculosis, we still rely on the microscope examination of sputum, a method developed more than 120 years ago and that only allows the detection of 45-65 percent of cases.This rate is even lower for patients infected by both HIV and TB," says Nobel Peace Prize laureate Dr. Marie-Eve Raguenaud, a TB specialist with MSF.
"Due to the limitations of the test, the treatment of half the patients in developing countries is often delayed or not started at all," she warns.
Read her call to also include children in TB-diagnosis:
In a struggle to find a new user-friendly and more efficient diagnostic tool, MSF is developing new tests, by evaluating the viability of new technologies on its field operations. 'While waiting for a rapid and efficient diagnostic test, MSF teams also consider new methods to simplify clinical TB diagnostic in children' highlights Dr Raguenaud. 'Also diagnosing children at the health centre level, (instead of just adults) and not only by a doctor at the hospital, would allow the detection of more cases'.
TB+HIV patients get 13 - 16 pills a day with serious side-effects...
Regarding treatment, it already is very difficult for TB patients but gets even worse for patients co-infected with HIV/AIDS.
"These patients have to take between 13 and 16 pills a day. Also, there are interactions between AIDS and TB treatment which cause side effects like liver problems or allergies," highlights Dr. Van Cutsem who coordinates one of MSF's programs in South Africa.
Full report on the severe health worker shortage in SnAfrica:
The report covers four southern African countries­Lesotho, Malawi, Mozambique and South Africa:
http://www.doctorswithoutborders.org/publications/reports/2007/ healthcare_worker_report_05-2007.pdf
Address: Doctors without Borders/Medicins Sans Frontieres
333 7th Avenue, 2nd Floor
New York, NY 10001-5004
By Phone (212) 679-6800
By Fax (212) 679-7016
By Email: michael_goldfarb@msf.org
Michael Goldfarb Press Officer
Telephone Direct: USA (1) (212) 763-5783



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